▶ 0:20:57As well. We have two boats starting at 11:30. Most of us have now cast that first vote. We will be interrupted on a rolling basis, I would guess, for the second vote. Mr. secretary, thank you for testifying before this committee . It's the first time before this committee since you were sworn in to be confirmed as secretary of veterans affairs.
▶ 0:21:23Thank you for your acceptance of my invitation and your willingness and ease with which you agreed to come before the committee at the appropriate time. The v.a. Has been operated by many hard-working and caring staff members, many of them are veterans themselves, their bureaucracy has handled -- hampered success. The current way of doing business at the v.a. Is not always working for every veteran or military family.
▶ 0:21:52I hear from kansans, as I assume we do as members of congress, we talked to kansas veterans regularly. Speak to their loved ones. As well as kansans who work for the v.a., medical facilities, better in, about the challenges they are facing. I look forward today to hosting you in kansas and sometime in the near future where we will visit those veterans and those employees.
▶ 0:22:20This committee has worked to improve the v.a., to approve its services for men and women around the country to rely upon the health care benefits and services the v.a. Provides. Most of the time, we have done that in a bipartisan way. And we have made progress. The mission act made the v.a. Care more accessible and enabled veterans, particularly those in rural areas, to receive care closer to home.
▶ 0:22:48It started out as the choice act. The pack act expanded health care and benefits to millions of veterans exposed to burn pits and other toxins during military service. As we always say in this committee, more work remains to make this agency in this department, the second-largest bureaucracy and the federal government, perform to the levels that veterans, their families, and staff members deserve. I believe that we share many of the same priorities, Mr.
▶ 0:23:19Secretary, including eliminating waste to better serve veterans. During the last three months there were announcements about significant changes across the department including contract cancellations and plans for large-scale reductions in force that could see the v.a. Return to the top line workforce numbers in place six years ago. It has caused understandable concern among veterans and staff, as well as many of us up here. Mr.
▶ 0:23:47Secretary, I look forward to you addressing those concerns this morning. I think that how this process is completed or occurs is hugely important. I have told you on the phone that it ought not be a set number you are trying to reach, it ought to be about rightsizing the department. It's at a critical juncture. Perhaps that is always true.
▶ 0:24:13I want to hear from you that the changes underway are backed by data, informed by veteran demand, focused on improving outcomes for the men and women served by the v.a., to be carried out in close coordination with this committee with veterans, v.a. Staff, and veteran organizations. As the v.a.
▶ 0:24:34Undergoes restructuring, the department must be well staffed by quality, accountable workforce and any efforts to right size it must be done carefully in a manner that treats men and women who entered public service to care for veterans with gratitude and respect. I believe that we can work together to achieve lasting and positive changes at the v.a. That best serves veterans, staff members, and survivors, done in a way that is the right way to do it. Mr.
▶ 0:25:03Secretary, I indicated in one of our last conversations that if you work rightsizing the department of veterans affairs, numbers higher or lower, that's not the issue. The issue is about making it the right size for those who care for our country. With that, I yield to senator blumenthal, ranking member, for his opening remarks.
▶ 0:25:27Sen. Blumenthal: Thank you, Mr. chairman, and I want to thank you, senator moran, for bringing us together for the bipartisan work that you and I have done together. This committee has been more bipartisan than any in the united states senate, so far as I'm concerned. It will continue to be so. Championing -- championing measures like the pack act, which sec.
▶ 0:25:55Sen. Blumenthal: Collins, by the way, I just noticed, is not mentioned once in your written testimony. That mystifies me. Let me say at the outset, I would like to enter a few items into the record. The first is an article published this morning by pro-public, supported by hard evidence and in-depth conversations with v.a. Staff.
▶ 0:26:22Sen. Blumenthal: It outlines a number of examples of real-life impacts to veterans caused by the firings, freezes, and cuts in this administration. It also outlines the warnings of what's to come, documents with recommendations from doge. The tech boys. I called in the doge dopes that outlined cutting 100,000 employees and closing as many as 17 v.a. Hospitals.
▶ 0:26:51Sen. Blumenthal: I would like to enter into the record a statement from the president of the fg local 0025. His statement is a summary of dozens of impact statements from v.a. Employees that were provided in my office this morning.
▶ 0:27:11Sen. Blumenthal: In addition, "the new york times" article on mental health care, diminishing and degrading privacy available through tele-mental health care that is absolutely unacceptable. In the words of Mr.
▶ 0:27:27Sen. Blumenthal: Pennant, his statement represents the collective voices of foot front line public servants who have endured significant and unjustified hardships stemming from recent management decisions and failures to honor basic labor protections.
▶ 0:27:47Sen. Blumenthal: Finally, I want to submit for the record an updated list of 41 requests for information and 19 letters of inquiry that have been sent to this administration without substantive response. Any sufficient response, or any response at all. If that is ok, Mr. chairman, without objection.
▶ 0:28:13Chair Moran: So ordered.
▶ 0:28:15Sen. Blumenthal: We are here about accountability, which so far has been totally lacking. The absence of responses to our inquiries are simply unacceptable. You inherited, Mr. secretary, a v.a. Delivering a record amount of health care. Last year, wait times decreased despite a record increase in new patient appointments.
▶ 0:28:41Sen. Blumenthal: You claim the disability backlog scupper -- got worse, but the percentage of backlog claims is about the same. Increasing challenges in numbers. V.a. Has decreased the amount of time to process each claim, setting new records for productivity. You inherited a v.a.
▶ 0:28:59Sen. Blumenthal: That was setting new records for burials, which is important to the service members, families that sadly have to provide those burials. The v.a. Has been delivering more care, more services, more benefits to more veterans, doing it faster than ever before when you over. That is in no way to deny the importance of improvement.
▶ 0:29:30Sen. Blumenthal: Call it form, call it revision. Improvement is absolutely necessary. But it shouldn't be done with a chainsaw. The head, the commander of the veterans of foreign wars came before us and drew this analogy. When he was wounded in combat, a surgeon used a scalpel.
▶ 0:30:02Sen. Blumenthal: Took the shrapnel out of his arm. He didn't using a meat ax. He did not use a chainsaw. That is the kind of improvement we should work to achieve with the input of those skilled and dedicated caregivers who are working hard in the v.a. Right now, one third of them veterans. Thousands of them, already fired. Others, potentially, losing their positions in the future.
▶ 0:30:35Sen. Blumenthal: You have announced the cancellation of 800 contracts worth alleged $2 billion, only to rescind that statement once the harmful impacts of the cancellations were made public. And we protested. You arbitrarily fired thousands of v.a.
▶ 0:30:52Sen. Blumenthal: Employees, including that are in crisis line employees, only to subsequently reinstate a number of them after public backlash or after you learned that they were fired by mistake. And we protested. You have delayed the opening of facilities across the country only to announce that they would open in phases because of insufficient staffing. You have equated them to restaurants. You claim that that is how it has always been done. But that's not true.
▶ 0:31:25Sen. Blumenthal: So far is that 83,000 number is concerned, apparently you want to go back to the 2019 numbers because since then some 80,000 v.a. Workers have been added to the roles. You should know, two thirds of them are health-care workers.
▶ 0:31:52Sen. Blumenthal: If you cut those health-care workers, v.a. Quality and access will diminish. A number of them are v.a., vba claims processors. One third of them. If you slash them, the pack act benefits will be delayed.
▶ 0:32:21Sen. Blumenthal: I think that oversight is absolutely necessary and improvement is always possible, but it should be done positively, without the slashing and trashing that right now you have advocated. In the real world, we know that support personnel are absolutely necessary. Answering the phones. Cleaning the surgical equipment. Preparing the operating rooms.
▶ 0:32:50Sen. Blumenthal: Scheduling the appointments, fixing the I.t. Systems. Those burdens will fall to others or fall through the >> if you slash and trash the v.a.. In connecticut it is operating without a locksmith, that is not exempt from your hiring freeze. The v.a. Ignored local requests for the exemption.
▶ 0:33:15Sen. Blumenthal: There is no way for a va facility to operate reliably and safely without good locks on the doors. Now, that position might seem like a minor or trivial one. But every member of the v.a. Team is necessary to make the team effective. And efficient.
▶ 0:33:42Sen. Blumenthal: We have already begun seeing the results and the local impacts of staffing shortages. We heard directly from veterans. My office has. Colleagues have. Service lines at numerous hospitals and clinics have been reduced. Mammogram appointments have been postponed. Prosthetic employees have been fired, service is reduced.
▶ 0:34:08Sen. Blumenthal: The availability of operating rooms and inpatient recovery emergency room and long-term care beds have been reduced. Probationary staff in logistics and procurement have been fired. Meaning that critical medication and equipment deliveries have stalled. In some v.a. Hospitals, senior and clinical staff are helping to stock supplies.
▶ 0:34:35Sen. Blumenthal: Medical center employees who manage research grant applications have been fired, leaving hospitals unable to apply for new research funding. Countless employees are being driven away. You have 40,000 openings right now that you are recruiting to fill at the same time you are firing 80,000. It makes no sense.
▶ 0:34:57Sen. Blumenthal: How do you expect to recruit qualified, skilled, dedicated, new workers, be they physicians, counselors, nurses. When you are firing probationary employees who are the future of the v.a. List force, or who has been promoted because they were promoting -- performing with such excellence. Nonsensical.
▶ 0:35:26Sen. Blumenthal: So, I think that you owe this committee some explanation. You have refused to do it so far in response to the 19 letters I have written along with colleagues and of the 21 other inquiries. There needs to be accountability. We need to avoid the potential disaster that is looming.
▶ 0:35:53Sen. Blumenthal: Make no mistake, it's a disaster that is on the horizon, approaching us as surely as a thunderstorm in the nation's capital. We need to avoid it. It will be a self-inflicted wound that disastrously affects all of our v.a. Beneficiaries, whether they use health care or the pack act.
▶ 0:36:24Sen. Blumenthal: That is one reason why I am advancing the putting veterans first bill that would mandate rehiring all of fired v.a. And all of the veterans who have been fired from the federal workforce in other agencies. Give them the right to individual, personal determinations, which should be there right under current law. We need to make the v.a. A place that works better for veterans and their families. They deserve nothing less.
▶ 0:36:55Sen. Blumenthal: Thank you. Mr. chairman?
▶ 0:36:57Chair Moran: Senator, thank you. Mr. secretary, we now recognize you. Thank you for your presence and we recognize you for your testimony.
▶ 0:37:08Sec. Collins: Thank you. I appreciate that. Ranking member, distinguished members of the committee, thank you, good to be back here.
▶ 0:37:18Chair Moran: Can you get closer to the microphone?
▶ 0:37:22Sec. Collins: It's on, I'll have to swallow it.
▶ 0:37:24Chair Moran: All right.
▶ 0:37:26Sec. Collins: Showing up every day to work with these men and women has been one of the greatest experience of my life. I have listened to those employees and others who have expressed concerns about what is going on in the stuff that they need to be able to do to perform the job. Most of those are a bureaucracy that's out of control and hasn't been tamed in years.
▶ 0:37:53Sec. Collins: In the same amount of time, since I have come to learn from many of you, v.a. Needs reform. I could quote almost every member of the committee who stated in the past multiple times, including last year, that the v.a. Needed reform and needed it badly. We must do a better job serving veterans and getting to yes with the veterans benefits they have earned and make sure that the money appropriated today is not diverted to wasteful programs.
▶ 0:38:20Sec. Collins: Way back in 24, congress, they discussed many times reform, but it was often a thinly veiled request for more employees. History shows that adding more to the system doesn't automatically equal better results. Just about -- the biden administration, for her record. Last four years, I'll be happy to talk about it, it showed that the issue of money and people don't solve the problems.
▶ 0:38:46Sec. Collins: The number of employees grew by 52,000 full-time equivalents from 21 to 24. It all of those people make things better for veterans question mark no. V.a. Performance got worse. Wait times for primary care rose from 15.7 days to 24.3 days. Wait times for mental health care rose. Wait times for specialty care went from 24 days to 38 days. Under the v.a.
▶ 0:39:14Sec. Collins: Disability benefits backlog, that increased to 260,000 when I took office at the first of february. I will say that we have decreased by 40 thousand since taking office. Something has to change. We will have to change it. The president look at the problems and said take care of our veterans in a way that takes care of the families, caregivers, and survivors.
▶ 0:39:40Sec. Collins: I've never been shot in addressing tough issues and I won't ignore the elephant in the room. As has been discussed, we are looking into staffing across enterprise. Countless times, I've said that this is aimed at ways to improve health care without cutting care and benefits for veterans. Our goal is to increase activity and eliminate waste, increase efficiency, improving health care to our veterans.
▶ 0:40:07Sec. Collins: We will maintain mission essential jobs like doctors, nurses, phasing out nonessential goals, like interior designers. D.e.I., these are savings that I can achieve through veteran health care benefits. The goal, here's the key word, as we look at it as it goes forward, is a 50% decrease. If the goal. As the chairman said, could be less, could be more.
▶ 0:40:35Sec. Collins: This is all you have to look out, you have to start somewhere. Year after year the calls for v.a. Reform come from every corner. Lawmakers, media, watchdog groups, government accountability office, the sros, individuals across the country. We have embarked on a historic effort to reform the v.a. And have been emphatic that we will not cut benefits and health care, only improve them. I think the budget shows that.
▶ 0:41:01Sec. Collins: We are engaging in career subject matter experts, senior executives, political leadership to restructure. Scalpel, not hatchet. We are doing -- we are also dealing with the veteran's stakeholders and what they agree needs to be done. There has been action in which we were met by barrages of false rumors, speculation, implying forcing staff to work in closets in showers in that there is chaos in the department, none of which have been backed up.
▶ 0:41:34Sec. Collins: Even articles from today. Why? Because we canceled some contracts for the v.a. That we should be doing in-house and we let go less than one half of 1%, let go of one half of 1% of non-mission-critical employees. To hear critics tell it, that apartment was perfect before january of 2025. Everyone knows that's not true. The fact is, v.a. Health care has been on the high risk list for a decade at gao.
▶ 0:42:07Sec. Collins: They face systemwide challenges in overseeing patient safety, access to care, hiring staff, meeting future infrastructure needs, working hard to fix these and other issues. We need your help. We want to work with congress to fix the v.a., but shared goals need to make things better, not protecting a broken bureaucracy. It's not a federal jobs program. It's an organization whose sole purpose is to serve veterans and we must never lose sight of that.
▶ 0:42:36Sec. Collins: In the first 100 days we focus our core mission back on the veteran if not the v.a. Itself, making sure that they get a choice in the mission act, which is what the law requires. Over the last few years we found that has been stifled at the v.a., instead of sending people to community care they were encouraged to stay in care. Inside the v.a.. We brought back people from work. We accelerated the deployment of electronic health care management records.
▶ 0:43:04Sec. Collins: Yes, we processed record numbers of disability claims and redirected millions from noncritical efforts to support beneficiaries. Going forward, we are just getting started. There is a lot that we can agree on. There might be some things that we disagree on. Mr. chairman, ranking member, members of the committee, we have got to take care of our veterans and the numbers we have seen over the last few years show we are not. With that, you'll back.
▶ 0:43:29Chair Moran: Thank you. So, in your time as the secretary, and in the circumstances that you are under and engaged in, what do you assess as you most significant areas of concern for the v.a. And what do you believe is working and is there anything you have learned that needs to be done differently?
▶ 0:43:52Sec. Collins: One of the most interesting thing is constantly fighting rumor and innuendo, much of which we will hear today and I will try to put it to rest. One of the things as I had to take it from me perspective of being on the gao list. I expressed to many of you during confirmation what is working right and not working right. As we look at this I found a system of bureaucracy that was broken. Here's an interesting stat that most of you may not know.
▶ 0:44:20Sec. Collins: I came into the office and it took me 1.5 weeks before the human resources department could produce a list of all of the employees we have. 1.5 weeks. Because our systems were so broken and bureaucratically challenged. We didn't address -- I found out we didn't address any of the major concerns. Wait times, which I just outlined, have gotten worse. Backlog, got worse. All as we added people and money. Inefficiencies are interesting. I will show you one example.
▶ 0:44:52Sec. Collins: Under the previous administration they were trying to consolidate payroll. Payroll across the board, we asked for a number on payroll and got 200 30,000 as the employee base, that's who we are paying. We know we had almost 400 70,000. The reason? 50 to 60 hospitals still did their own payroll instead of it being centralized efficiently so that we could all have it where we need to go. The hr system, disarray.
▶ 0:45:20Sec. Collins: Death by suicide number hasn't changed since 2008, yet we are spending 588 million dollars per year to look at that. 2.3 billion in counseling and care. These of the things we have seen so far. We have implemented going forward to fix and move forward, but to say that where we came in was ok and needed tweaks was not true and the veterans in this room and others know that.
▶ 0:45:46Chair Moran: You mentioned in your opening statement the inspector general. I have indicated that I think that in many conversations, certainly the hearings in which staff are witnesses, the return of an inspector general is a high priority. What is the plan?
▶ 0:46:06Sec. Collins: We have encouraged the inspector general to be named and look forward to that being in place. We look at that as a metric of how we can be better. Last 10 years, that was the metric for saying we were at high risk. We welcome the oversight to make sure we are hitting the metrics needed to take care of veterans.
▶ 0:46:24Chair Moran: So, your impression that you leave is that the white house, the president needs to nominate someone?
▶ 0:46:31Sec. Collins: That's the next step, yes.
▶ 0:46:34Chair Moran: Ok. I want to ask a specific question. Community care. I appreciate your attention to the mission act. We have been trying, this committee, we believe it is particularly important for veterans at risk of suicide and mental health issues, veterans who were potentially victims of overdose deaths, I wrote to the
▶ 0:47:07Chair Moran: V.a. In january urging mental health rehabilitation treatment programs to be included under existing community care access standards, to immediately expand access to lifesaving services to veterans across the country and the community. Can you give me an update on the progress to end mental health rehabilitation treatment programs in those standards?
▶ 0:47:28Sec. Collins: Yes, we're going through that right now and adding those to make sure the v.a. And veterans are going through programs that are suitable and need to take care of the needs of the veterans, some moving forward we agree that any opportunity we can take to give more service.
▶ 0:47:49Sec. Collins: Something else to think about here, one of the things that I have, that I didn't mention earlier, there seems to be at times a difference in how we deal with the v.a. As opposed to health care in general. Some of that needs to change in the sense that v.a. Is the largest health care provider, but we share the same challenges as the community with doctor recruitment, nurse shortage, doctor shortages, mental health workers and those.
▶ 0:48:17Sec. Collins: We are working those areas to make sure we have good community health and partners in this regard, hiring the best we can. Also leveraging partnerships with doj, dod, and looking at our nonprofits to see how they can help as well. It's a total approach and we want to continue it.
▶ 0:48:35Chair Moran: Senator blumenthal?
▶ 0:48:37Sen. Blumenthal: Thank you. You know, I listen to you recite the problems you encountered. Not a single one of them will be solved or addressed by slashing the v.a. Workforce by 83,000 people.
▶ 0:48:59Sen. Blumenthal: Putting those workers on the chopping block fails to address one single aspect of any of the problems that you have brought to this committee or that you encountered. Are you aware, Mr. secretary, that the va change the way it calculates wait times in 2022? >> the information I gave you was as of the current system.
▶ 0:49:25Sen. Blumenthal: The information that you gave us is deceptive and misleading, because the v.a. Change the way that it calculates wait times in 2022. In addition, because it begins in 2021 at a time when a lot of v.a. Patients were coming back to the v.a.
▶ 0:49:47Sen. Blumenthal: After covid in 2022, this information is fundamentally deceptive and misleading. I ask you to go back to the v.a. And correct it in a written submission to this committee. Mr.
▶ 0:50:06Sen. Blumenthal: Chairman, I ask that we enter into the record an article that appeared in "the new york times," entitled "what elon musk didn't budget for, firing workers costs money, too." no objection?
▶ 0:50:24Chair Moran: Without objection.
▶ 0:50:26Sen. Blumenthal: Are you aware of the costs that will result from firing those v.a. Workers in compensation that has to be paid to them when they have been wrongfully terminated?
▶ 0:50:40Sec. Collins: Mr. ranking member, if you look at that from that perspective around calls to moving forward, there are Sen.
▶ 0:50:49Blumenthal: Perspectives -- perspectives --
▶ 0:50:50Sen. Blumenthal: You don't have a number because you haven't calculated it. And then you've reinstated them with the courts tell you, as they will, they were wrongfully terminated.
▶ 0:51:02Sec. Collins: Talking about less than .5%. You have thrown out numbers of thousands. This is what I'm fighting against.
▶ 0:51:11Sec. Collins: It may be a small part of your workforce, but sec.
▶ 0:51:15Collins: They are the physicians. I will not let you do that. I will not let you sit here and scare my veterans and my boys, there has been no -- you must have stuff that, you know, again, you are looking at making a prediction in the future. No one has discussed firing doctors or nurses. We have said we are keeping frontline health care. If we want to continue this message that these are out there when you have no knowledge of what you just said, speculation and innuendo.
▶ 0:51:43Sen. Blumenthal: Let's start with facts. Will you submit to us, would you have failed to do, specific positions where workers have been fired already?
▶ 0:51:52Sec. Collins: At this point in time, if we submitted to that, and you said something I need to address real quick --
▶ 0:51:59Sen. Blumenthal: Wait a second, please answer my question. Will you give us the information? We have requested it again, again, and again. What positions have you terminated into what is your plan for termination in the future?
▶ 0:52:13Sec. Collins: First off, I will get you that information. Check back area plans for the future, this is the interesting thing. What we are trying to do here is go through a process that I talked about in my opening statement that deals with career employees, professional staff, and other outside consultants to see the proper size of the v.a..
▶ 0:52:33Sen. Blumenthal: You're running at the clock, I know the tactic. We both know it, you served in the U.S. congress, too. You can fill the air with words. But veterans deserve his action and accountability. We have asked for this information repeatedly. You have said you are firing 83,000 people.
▶ 0:52:55Sen. Blumenthal: If you fire the people who have been hired in the last five years, you will be firing physicians, nurses, surgeons, counselors, workers who are frontline. You cannot slash and trash the v.a. Without eliminating those essential positions that provide access and availability of health care. It simply cannot be done.
▶ 0:53:23Sen. Blumenthal: You may give us a lot of verbiage here, but you are not giving us facts. Facts are essential to accountability. That is why you are supposed to be here. But you are not giving us the facts that we need.
▶ 0:53:38Sec. Collins: Can I answer the question? With all due respect, the verbiage is being said from the dais as well. I would like to say, as I have set already and this hearing, there is a goal of looking at a 15% reduction. You have stated on several occasions already that I am saying we are going to fire 83,000 employees. That is wrong. I would appreciate that being corrected, it's not true.
▶ 0:54:03Sec. Collins: I said we are looking at a goal of how many employees we have and how many are working on the front line. I have doctors and nurses right now that do not see patients. Is that helping?
▶ 0:54:13Sen. Blumenthal: Yes, it does. A doctor who consults on a case, a doctor who consults, a doctor who advises, a doctor who looks at radiology reports.
▶ 0:54:26Sec. Collins: You're Sen.
▶ 0:54:29Blumenthal: Missing the Sen.
▶ 0:54:29Blumenthal: Point. A doctor who oversees and ensures quality? Absolutely, yes.
▶ 0:54:33Chair Moran: Senator tuberville?
▶ 0:54:39Senator Tuberville: Thank you for being here, thank you to our veterans here today. I wanted to pass on the thanks with a 400 thousand veterans from alabama. In two months they have seen progress and a lot of the v.a.'s in my state. We set a record number of dissolute -- disability claims to be processed. Employees returning to work. Ending d.e.I. Programs like treatment for gender dysphoria.
▶ 0:55:05Senator Tuberville: The days of business as we all are noticing and hearing today are over and finally our veterans are being put first. Let's talk about the budget, a little bit. Over the last 10 years the v.a. Budget has more than doubled in the number of employees at the v.a. Has increased more than 100,000. The number of veterans in our country is declining. V.a. Enrollment has changed. It has become a bloated bureaucracy. I think most of us will agree with that.
▶ 0:55:36Senator Tuberville: Why has the v.a. Budget become so bloated over the last 10 years if the veteran population has remained stagnant?
▶ 0:55:42Sec. Collins: Appreciate the question. It's another number that we are leading with as well, the veteran population enrolled in the v.a. Is 89.1 billion. Again, we can talk about numbers all we want, but it has been 9.1 million steady for the last 10 years. So, we are losing veterans is a total population is not gaining in the enrollment of the v.a.
▶ 0:56:10Sec. Collins: Some people say that we have had an increase in different programs, but we also lose 400,000 to death and natural causes. It's a priority of function. But we are looking at here is programs that have been increased with mandatory spending increases and other things that we look at. I think that what we are actually looking at is the decision that we want to, that it is easier to just put money and people towards issues without looking at whether there is any real world aspect of the costs.
▶ 0:56:42Sec. Collins: As you talk to veterans, as I go out and talk to veterans, one of the things we have is that those amounts of numbers and people are not equating into how we can actually function. I appreciate the ranking member's service and I appreciate that we disagree.
▶ 0:56:57Sec. Collins: When we have doctors and nurses and other clinicians who are not actually reading charts or doing things, they are actually, you know, formulating policy work doing administrative work, when I have this many folks that need to be in the clinics, we are not helping the veterans. It's something that isn't happening.
▶ 0:57:15Sec. Collins: When you take time to process disability claims that go up and then don't have the proper, you know, computer ai technology to help us do that, but also point out the issues that are slowing up? We get in our own way. We are such a bureaucratic organization. Rules over rules over rules. I had a gentleman tell me just the other day, and again, I seen this before from my own daughter, he was a double-amputee and said I have to go to the v.a.
▶ 0:57:45Sec. Collins: If I need a new wheelchair I have to go to the primary and ot before I get an appointment. Why do we have that kind of mess to get straight out of where we know they need to be to start with.
▶ 0:58:00Sen. Tuberville: I often hear about the large amounts of paperwork and administrative burden that v.a. Doctors are forced to navigate when seen paperwork -- patience, leading to them seeing less patients per day. Where do you see the opportunity to reduce these administrative processes? 1 there are plenty of opportunities there. It's just about are we doing it efficiently.
▶ 0:58:28Sen. Tuberville: I've made a statement to every hospital and clinic that I go to, every veterans benefit office I go to. I say -- tell me, what is, if you had 10 sheets of paper to get a veteran the services they need or 10 sheets to do the next thing, can you do it with five?
▶ 0:58:47Sen. Tuberville: Showing you an example, to apply for benefits in our vba, there is a sheet on there that is on there, it has a full listing of the veteran as far as basic information about their military service. For older veterans it could be a problem to go back and remember dates. If the veteran served in we can do web -- do that with their numbers and names, we can gain all the records we need to make sure.
▶ 0:59:16Sen. Tuberville: Yet we are making them go through the process of filling out a form that many veterans who may or may not have computer capabilities are having trouble with. It makes it difficult.
▶ 0:59:26Sen. Tuberville: I have heard from some supervisors in the v.a., they say that we used two coating systems. One, the hospital system that is very effective. The other one is from the who a useless piece of crabp. This comes from them. Why do we use both?
▶ 0:59:45Sec. Collins: I'm looking at that now to try to streamline the issues we have in the system. Again, it is interesting, a lot of times we wind up talking about processes and plans without talking about actual care and the veteran experience. Most, I will tell you, a lot of times when they get through the labyrinth of stuff to get there, they are happy with the service that they get. They appreciate it.
▶ 1:00:12Sec. Collins: When we actually put restrictions on our employees and on veterans getting in, it makes it all the worse.
▶ 1:00:20Chair Moran: Senator murray?
▶ 1:00:24Senator Murray: Thank you for being here, thank you for taking the time to talk with me yesterday morning about the new policies that you know have related to congressional engagement. For all of my colleagues, this new policy will limit our ability to interact with veterans on a v.a. Campus as it did when I was denied the ability to host a veteran provider roundtable. I will note, I have done that many times over 30 years here in the senate.
▶ 1:00:55Senator Murray: My staff was told that it was a new policy that had not been put into writing at the time that I got denied and I want to reiterate my request, Mr. secretary, that you share the newly written policy with every single member of congress.
▶ 1:01:09Sec. Collins: As we talked yesterday, this had been an unwritten policy for years. It had been applied differently. I went back and checked it, it was applied differently. Simply, there's over the tour we want you to have.
▶ 1:01:22Sen. Murray: I don't know of anyone who has been the night before. This is a new policy and it is important that you have it in writing to every single member that we all know that.
▶ 1:01:32Sec. Collins: Sen. murray: it will be.
▶ 1:01:34Sen. Murray: In our conversation yesterday and seen your responses to nearly all of the oversight letters I've seen, you are relying on this very broad explanation to everything, you say everything you do is to make sure veterans receive the care and services they deserve. I want to take the opportunity, Mr. secretary, to remind you that the people on this dais, both sides, have the same purpose. Many of us have been doing this for decades.
▶ 1:02:04Sen. Murray: Oversight is constitutionally required and critical for all of us to do our jobs. With that in mind, I would ask you to resend the memo from your chief of staff that allows him to personally sign off on proposed or planned engagement with any of the 535 members of congress, which stonewalls legitimate questions we have.
▶ 1:02:33Sec. Collins: That's a missing mischaracterization of that memo. We were simply coordinating to make sure our staff who deal with the budget side, like you do, are on the same page with veterans affairs. Basically not being on the same page.
▶ 1:02:52Sen. Murray: We have the letter, it says it has to be rerouted through the top. It denies us that ability.
▶ 1:03:01Sec. Collins: We will make sure that the legislative inquiries that you need go through the oversight. I agree with you, oversight is important. But getting you good information is also important.
▶ 1:03:11Sen. Murray: I appreciate that, is that letter no longer in place?
▶ 1:03:16Sec. Collins: The one that I'm familiar with is a letter to streamline information and we can get you the information quicker.
▶ 1:03:22Sen. Murray: Streamline to the top, so that our questions are reeded, that's -- never answered, that's how we read it. I would ask you to go back and look. Again, we have oversight responsibility and we all take it seriously. We need the responses and don't need weeks and months to go all the way to the top with one guy sitting there deciding on the information.
▶ 1:03:48Sec. Collins: We are trying to streamline it to get you more information. >> I have other questions. I mean it, I want you to go back and look at the letter, we all need the information. As you know, fixing the hr is about patient safety. During your hearing I expect concerns moving forward to be four additional new sites.
▶ 1:04:14Sec. Collins: They experience places of issue in walla walla. You said that when it came to hr you said you would "listen to clinicians and hospitals." weeks later, the v.a. Announced plans to fire a staggering 80,000 employees this year. Did you ask the v.a. Clinicians or hospitals about how the cuts would affect future phr deployments.
▶ 1:04:42Sec. Collins: >> the issue of employment is separate. We are not looking again. Can't emphasize this enough, none of our reorganization deals with front-line workers. It's everything from clearing up --
▶ 1:04:55Sen. Murray: That wasn't my question.
▶ 1:04:58Sec. Collins: Yes, we've included. Dr. evans has been working the program for over a decade.
▶ 1:05:04Sen. Murray: 20 seconds left. I've been very vocal about the troubling v.a. Decision not to renew the terms of researchers working on critical projects and clinical trials for veterans. There are planned trials that have not started, ongoing trials that have been stopped. There are trials that have fallen apart due to staff layoffs. Do you agree that clinical trials stopping would have an impact on care for veterans?
▶ 1:05:33Sec. Collins: Clinical trials are important and when we look at it they were trials that came to you like they always do. I put a 90 day stop on to examine it.
▶ 1:05:45Sen. Murray: Has a decision been made about what happens when the pause stops? >> we are currently in the process.
▶ 1:05:53Sen. Murray: They've got to wait 90 days and pray? >> some of those were stopped at the end. We are keeping some of them in line so that they can continue if need be.
▶ 1:06:06Sen. Murray: Thank you.
▶ 1:06:08Sen. Blumenthal: On behalf of the chairman, I recognize senator blackburn.
▶ 1:06:13Senator Blackburn: Mr. secretary, we are delighted you are here today. Thank you for your time. I want to say that I have been so impressed with the way that you tackled the phr program in that rollout. You and I discussed this in our first meeting and in your confirmation hearing, as well as when you were in nashville. Thank you, again, for making the nashville v.a. One of your first sops.
▶ 1:06:47Senator Blackburn: I know that you are planning to take the phr program live. Pardon me. In 13 additional facilities in 26. I know that previously we had an issue with v.a. Employees showing up for the training and then utilizing the system.
▶ 1:07:11Senator Blackburn: Talk to me a bit about how you are going to continue this rollout and then get the employees to actually use the system.
▶ 1:07:24Sec. Collins: I appreciate that, senator murray is no longer here, but we talked about this. When I found of the system on the v.a. Side of the house was that we are not going to do anything and make it all individualized, then on the oracle side you had them saying we could just finish this in a short amount of time. What we have done is said -- put the onus back on oracle to provide what they are supposed to provide.
▶ 1:07:49Sec. Collins: We also cut down on our side the amount of delay caused, which cause the initial problems in the rollout. Six locations doing six different things. We have taken eight or nine committees that have had to touch stuff before they could get back to a decision and brought it to one committee that can communicate directly with oracle to get it started. I appreciate that everyone on the dais, to everyone who got our deputy through, he is now working to oversee that.
▶ 1:08:19Sec. Collins: We are bringing in others right now and I have committed to him any help that he needs to make sure our system is safe and useful for clinicians, to make sure they have that.
▶ 1:08:34Sen. Blackburn: The employees instructed to go through training, they have shown up and done training?
▶ 1:08:41Sec. Collins: As far as I know. Sen. how many employees have ben released from the v.a. To date? Out of your totals?
▶ 1:08:56Sec. Collins: It was about 1000.
▶ 1:09:01Sen. Blackburn: That is helpful. I want to ask you about the budget. The president's budget came out last week. How did you view the resources that are in therefore modernizing the v.a. And can you give me some examples of how you are going to use these resources moving forward? So the v.a.
▶ 1:09:31Sen. Blackburn: Is more responsive in a timely manner?
▶ 1:09:33Sec. Collins: It is one that fulfills the commitment you talk about making sure our veterans are taking care of. That is the biggest issue when you look at the increases with all of the folks saying they will cut health care and benefits and all of this. It doesn't add up when you look at the budget itself. The increase on base budget and using funds as well.
▶ 1:10:01Sec. Collins: How do we then use that combined with the efficiency we are finding through our contracts to make sure we are paying more of those resources towards our clinical care. Also, I know this is a concern for yours but community care and how we balance the needs. This is how we provide the resources we need and funding that the health management systems.
▶ 1:10:31Sen. Blackburn: How do we shorten the time for movable -- moving into community care, they are willing to be a provider and it is so much more convenient for our government to get the health care that they have earned and to get it in their communities when they want, where they want, I think community care is something that should be moved on today.
▶ 1:11:03Sec. Collins: I have made it clear to every staff that community care meets the qualifications and if there is a catch fall that the doctor sees they could get better care they could actually do that. What we have found is for memos and others it has not been encouraged. There has been encouragement to keep everything in the v.a. We are moving forward with those kind of things. There is a community care group right now.
▶ 1:11:36Sec. Collins: I'm looking forward to seeing their findings in the next week or so. What we have found is some roadblocks being put in by our own processes. That is something that is very important to me and we will continue to look at.
▶ 1:11:51Sen. Blackburn: I will continue to work on that issue.
▶ 1:11:57Sen. Hirono: Facts are important. Why don't we get to some facts. You are asked how many v.a. Personnel have been let go. You said 1000. This committee had been given information that there were some 2400 who have been let go and trying to get back to 2019 numbers.
▶ 1:12:27Sen. Hirono: What happened to the other 1000 or so we were told were released by the v.a.?
▶ 1:12:32Sec. Collins: We are following the court order, they are back employed.
▶ 1:12:41Sen. Hirono: When you fired all these people or let them go, you didn't follow appropriate procedures and had to hire them back. Will that determine whether or not people --
▶ 1:12:53Sec. Collins: I disagree with the premise, we had one judge in one area.
▶ 1:13:00Sen. Hirono: We have other departments where they have fired people and judges said you have to follow procedure. In february, 2021 you claimed the v.a. Has saved millions of dollars by firing staff. How much have you saved? What is the amount?
▶ 1:13:22Sec. Collins: Those millions, there is probably a different number that I would have to get back.
▶ 1:13:32Sen. Hirono: Are you prepared to give us that information knowing that you will probably be asked for factual information? You don't know, even if you said that you saved millions of dollars by firing staff.
▶ 1:13:47Sec. Collins: Let me re-clarify, we did say 14 million when we did away with d.e.I.. My next question is where is all of that money going? You saved millions of dollars, now you are tested nine that you will have to get back to me and now you are saying 14 million.
▶ 1:14:16Sec. Collins: Could you tell me what unnecessary programs specifically you have cut and you have redirected those savings some $14 million to veterans and I would like to know specifically where these moneys were being directed? Do you have that information?
▶ 1:14:35Sec. Collins: The d.e.I., the $14 million have been directed to those with disabilities. A part of that was also contract that were either terminated or renegotiated.
▶ 1:14:48Sen. Hirono: You need to tell us exactly what contracts have been terminated. You have to have a reason to terminate or else you end up having to pay.
▶ 1:14:58Sec. Collins: In the contracts when you are going through renegotiation you have to make sure you are doing it properly. We will give you all the information you need.
▶ 1:15:11Sen. Hirono: I would hope you would have all of that specific information today. You have 500,000 employees at the v.a., does that sound right?
▶ 1:15:22Sec. Collins: No we do not.
▶ 1:15:24Sen. Hirono: What is the number?
▶ 1:15:27Sec. Collins: About 470.
▶ 1:15:31Sen. Hirono: Is getting close. What categories are they employed? How many nurses, doctors, you have the 470,000 employees broken down by categories of jobs?
▶ 1:15:46Sec. Collins: That is part of our problem. I laid that out in my openings.
▶ 1:15:53Sen. Hirono: You don't know, you don't have that information?
▶ 1:15:56Sec. Collins: We have 300,000, probably closer to 400,000, we couldn't find some of these when our hr people started to look. If you want a direct answer, I'm giving you a direct answer.
▶ 1:16:14Sen. Hirono: You have a lot of people working for you. Who are you actually going to let go when you get to the 29 he numbers that is your goal? You had some questions about the clinical trials. It's important to provide health care services to our veterans. You know how many clinical trials are in pot? You know how many veterans are in clinical trials?
▶ 1:16:40Sec. Collins: I would have to get that number back to you.
▶ 1:16:45Sen. Hirono: Are we talking about 1000 clinical trials? Could you give me a ballpark?
▶ 1:16:56Sec. Collins: I'm not going to ballpark because it will be used against me next time I'm here.
▶ 1:17:03Sen. Hirono: They are not getting the health care services they need, that is what a clinical trial is. You are seeing doctors, you put these trials on pause, you cannot tell me how many veterans are being paused. You can't tell me how many veterans are enrolled in the michael trials. You also can't tell me how many clinical trials impact. You have 9 million veterans that you are take care of.
▶ 1:17:31Sen. Hirono: Clinical trials are very important, you said so yourself. I have other questions, it is very clear our secretary has not come with much in the way of numbers. I really don't know how he will go about eliminating, getting to the 2019 figures of cutting employees when he can tell us what the categories are. I think we will need to hear from Mr. secretary again.
▶ 1:18:02Sen. Hirono: Would you commit to coming back to provide us the kind of information we are asking or?
▶ 1:18:07Sec. Collins: I will get you the information you ask for.
▶ 1:18:12Sen. Hirono: Will you come back to testify or is this it?
▶ 1:18:15Sec. Collins: I will get you the information you are looking for.
▶ 1:18:20Sen. Hirono: We are not getting any commitment to come back to this committee to provide responses. This says a lot.
▶ 1:18:28Sen. Tillis: Good morning. How are you doing? Thanks for the few minutes we just spent in the office. I was going to ask you some other questions until I ran into oaks at the elevator confirmed -- concerned about the 83,000 cuts in the v.a. They asked me specifically what I publicly oppose those cut. I said I can't.
▶ 1:19:00Sen. Tillis: Do you know where they are? Are they potential cuts that will improve access, outcomes or cost? My question to you, I don't think cuts are real unless there is a package sent to the congress so that we codify those cuts.
▶ 1:19:22Sen. Tillis: My commitment to the fulks I was talking to, if it's at odds with what I consider to be in the best interest of the vai might vote against it. Could you give me an idea how you would stack each of those 83,000 jobs and could we expect at some point in the future to have a package?
▶ 1:19:43Sec. Collins: The biggest thing here that we have to understand is I don't care what side of the aisle you are on, you don't just go say go do something. That has been happening at the v.a. For a long time. You get some who are interested, some who are not. Everybody categorizes and I have been accused of firing any thousand.
▶ 1:20:13Sec. Collins: Nobody could predict that on either side of the aisle and say that many people will be fired. When you take a 470,000 person organization and you look at its efficiency when it's between the hospitals and central office you have added significant layers of bureaucracy that go into this. I'm not going to play it out in a public ring.
▶ 1:20:40Sec. Collins: If we start saying here is everything we are looking at you start in a decisional kind of format. Some of them might be in the audience. I asked them how do you stack it? Tell me which specific positions you are concerned with. Obviously they don't know the answers because I don't know the answers. Is the v.a. Just great? Do we put it on autopilot?
▶ 1:21:11Sec. Collins: When people say don't change, you are happy with the current state. A poorly implemented at that I tried to get people to hold off on. Don't be against something because it is new. I have extra copies in the office. We have to move the cheese. We are not performing. When's the last time I heard people stand at a parade and say appointments are rocking.
▶ 1:21:41Sec. Collins: When's the last time I heard electronic health records were great. The v.a. Is not working for veterans. If we just say everything has to say the same, you are looking at it the wrong way. They be at some point when we prove that we are improving access, improving outcomes, reducing costs, when those policies come before me I get excited.
▶ 1:22:14Sec. Collins: I'm open to anything that will improve the service on a debt that we could never fully repay. We need to be honest and tell them change is necessary to do that. To the veterans I met with, you could use this response, this response as I'm open to any suggestion that improves the condition for veterans, period. I can't say no to something because it makes me feel on come will.
▶ 1:22:44Sec. Collins: -- uncomfortable. I have confidence in you going through that process. I will make a judgment on your decision because I expect the package to make sure they will not be approved in the future. That's how I would complete my job as a U.S. senator. I'm not going to say don't change. We have to change to do a better job for veterans. We have to be a little bit uncomfortable going through it. You.
▶ 1:23:12Sec. Collins: I couldn't agree with you more. Again, hearing some of the comments and opening statements, I would've thought that up until january that there was no problems in v.a., the minute we start trying could we make things better? My only criteria I have is making sure we are taking care of the veterans first. That is the only criteria we are looking at.
▶ 1:23:44Sec. Collins: At the end of the day the metric is are we taking care of veterans?
▶ 1:23:50Sen. Hassan: Thank you Mr. chair and ranking member as well. Welcome secretary collins. Thank you for being here today and your own military service. Just a note to my colleague from north carolina, a lot of us have been working hard on reform at the v.a. Or a long time. We agree there needs to be changes. That is not what the question is about.
▶ 1:24:20Sen. Hassan: It is about whether the so-called changes you are making are being made with transparency. In your testimony you stated the v.a. Is an organization whose sole purpose is to serve veterans. You also publicly stated you plan to fire 80,000 employees. That is our goal. Roughly 25% are veterans themselves.
▶ 1:24:48Sen. Hassan: Meaning if you do follow through you will fire thousands of veterans. It is worth noting that the veterans health organization accounts for 90% of all v.a. Employees. You will end up firing roughly 70,000 employees. Is your goal 2000 -- fire thousands of employees who work to provide health care to our veterans?
▶ 1:25:14Sec. Collins: My goal is to make sure veteran care is done in the best possible way. Putting numbers in a way you have no blueprint for is not helping any veteran.
▶ 1:25:27Sen. Hassan: I'm basing my remarks and questions on your public statements as many of the other senators point, we are getting specific.
▶ 1:25:44Sec. Collins: The administrations, the vast majority are close to 350.
▶ 1:25:53Sen. Hassan: --
▶ 1:25:57Sec. Collins: 370,000.
▶ 1:26:00Sen. Hassan: It is actually impossible for you to fire 80,000 employees without firing those who help provide health care to our veterans. In all this back you seem to be trying to hide that.
▶ 1:26:15Sec. Collins: I want to respond to this, I have a question, my goal is to take care of veterans health care. When you look at an interior designer, is that taking care of health care. Those are the positions we are looking or.
▶ 1:26:32Sen. Hassan: If there are 200, you are talking about thousand employees, 54,000 employees work outside of vha. You will take a meat cleaver approach. The old adage, you guys have been cutting without measuring.
▶ 1:26:56Sec. Collins: We have not cut anything yet.
▶ 1:27:03Sen. Hassan: My time is my time. No one in the trump administration has been able to explain how cutting nearly one in five v.a. Employees won't hard -- harm health and human services for veterans. The top doctor in the entire v.a. Came before this committee and stated he has not been involved in any discussions about how firing 80,000 employees would -- impact care.
▶ 1:27:36Sen. Hassan: He had not seen any analysis as to how that would impact care. That is the v.a.'s head doctor. That a primary care, surgery, mental facility. Saying no one on your team has even bothered to ask him whether firing 1/5 of all employees would make health care better or worse for our veterans. Why haven't you asked the v.a.'s top doctor whether your plans to fire 80,000 employees would harm health air?
▶ 1:28:04Sec. Collins: I will not speak for anyone else. I will say this, they all have working groups and have been working on this process.
▶ 1:28:19Sen. Hassan: This doctor told us he has not been involved in any discussions. The department of defense may cut the army's active duty force by up to 90,000 soldiers. To cut the force by this much you could reasonably expect they are leaving active duty and returning to civilian life. They will almost certainly turn to the v.a.
▶ 1:28:45Sen. Hassan: How are they preparing to care for those soldiers and how does firing 80,000 employees support that?
▶ 1:28:52Sec. Collins: They will be taken care of. I cannot state this enough and we could continue this process. There has not been 83,000 people targeted for firing. There has been a goal. It is a nice talking point.
▶ 1:29:12Sen. Hassan: It is you're talking point.
▶ 1:29:14Sec. Collins: It is our goal. The goal is not a fact.
▶ 1:29:21Sen. Hassan: Do you want to reach your goal? Most people decide they would like to reach it. Revise your goal and tell us what you want to do in the analysis you have formed. You have a lot of people on both sides of this I'll. It is our primary honor to do it. We are asking to engage with you in a way to reform the v.a.
▶ 1:29:44Sen. Hassan: And make sure that health care and those services are therefore veterans. Tossing out big numbers and cutting before you are measuring is not the way to do it.
▶ 1:29:58Sec. Collins: Could I finish that? This is the problem that we have. This is the problem I saw when I was in congress. When we go into something and you look at it, you have to look at the process. You start with a goal and then you use the data you find to make the best choices you can.
▶ 1:30:27Sec. Collins: When you also start with the premise that is not true, it premise saying things that we are not looking at. We are not cutting the primary health care or cutting benefits, that is not helping in a collaborative process. The v.a. Is not working in the way that it should work. I'm trying to get it to a point where it could work for all veteran. The workforce is a part of that.
▶ 1:31:00Sec. Collins: It was perfect before this year started. That is not true.
▶ 1:31:07Sen. Hassan: That is not fair to the members of this committee. That is not a single person on this dais thinks.
▶ 1:31:16Sen. Hassan: I'm eager to engage in real numbers and not magical. This witness and the v.a. Cannot have it both ways. They cannot set out a goal and get angry at us for asking what the impact of those goals would be.
▶ 1:31:32Sen. Cassidy: Good to see you here. I was just with a press conference back home. If you need to get back to me on this I'm ok with it. They asked about the v.a. Servicing purchase program. There was a covid arab program helping veteran needed mortgage support.
▶ 1:32:03Sen. Cassidy: The biden administration abruptly ended it two years ago. Leaving veterans in the lurch. Apparently congress has not filled that void. I'm asking you about this. If you have to get back to me, that is fine. I'm challenging the members of this dais if congress needs to step up and do something.
▶ 1:32:33Sec. Collins: We don't need to be on the side we were. It was a discretionary part. We did not have those appropriated funds. I know there has been a lot of legislation that is coming through giving more partial claims that could give the veteran help in the situation they are in without having to go into the situation that was created.
▶ 1:33:01Sec. Collins: That is the story of where we are at. Congress has a role to play in that.
▶ 1:33:08Sen. Cassidy: Because senator hassan was saying some sort of objective analysis, you would agree, I think all of us would say the v.a. Needed some improvement. Thank you for taking on that job. I propose something called that pack, which would be pattern after medpac.
▶ 1:33:36Sen. Cassidy: It gives advice from an independent board objectively as to how to reform. Deserving benefits but doing it more cost-effectively for the taxpayer. We have suggested something called vetpac. We have reintroduced that this year. My question for you is we had submitted it for the legislative review.
▶ 1:34:03Sen. Cassidy: Your folks haven't got it for review. It is bipartisan giving us the objective reality that you guys like. Just a request that we walk out here, you call up somebody and say they want this, give it to them.
▶ 1:34:26Sec. Collins: They are getting it right now. We will get the technical assistance.
▶ 1:34:36Sen. Cassidy: One thing I have been concerned about, I'm a doctor, the fact that veterans if they are not in the v.a. Facility go to the private sector. There has not been a good utilization review or prioritization, that could be a bad word.
▶ 1:34:56Sen. Cassidy: I know of someone go someplace and there's no limit on the amount of testing they could award, there will be a lot more tests ordered and sometimes they are inappropriate and bring on complications, does that make sense?
▶ 1:35:10Sec. Collins: It does. We are making sure that we are looking that those equities are in balance as far as what the veterans need and the doctors have their authorization. That is something you and I spoke about with the third party administrator system. It tends to be something that is a marginal complaint because it is the conduit between the v.a.
▶ 1:35:40Sec. Collins: And the community. My first week I got there, one of the things I did find out was the groundwork had not been put in place for the renewal of contract. We had to delay that and go to the extra year. We are stuck in a year that we didn't ask for. It is now getting to the part we are putting in question where our contract will be much better in getting to the v.a.
▶ 1:36:09Sec. Collins: And the community on the same page.
▶ 1:36:16Sen. Cassidy: I think you're working at least 80 hour work, thank you for doing that on behalf of our veterans.
▶ 1:36:28Sen. King: There was a video of the cancellation of hundreds of contract, eight hundred 75 non-mission-critical, there was a lot of reaction to that. 24 hours the department made an internal announcement reconsidering that pause and cancellations.
▶ 1:36:55Sen. King: On march 3, another announcement, 585 contract had been canceled, they are non-mission-critical or duplicative. On march 5 asking to have a list of those 585 contract. We mentioned earlier today it is not weeks or months. In my case it is two month. Why won't you tell us what those contracts are?
▶ 1:37:19Sec. Collins: Ashose are finished as you well know, we are going into negotiation, part of those contract, they are not completely. When we get to the final we will be giving those.
▶ 1:37:39Sen. King: I just want a list of the contract, it has been two month. I'm an optimistic kind of guy, I'm not suspicious. The fact that you won't tell us what the contracts are makes me wonder if there are things in those contract that you don't want us to know about.
▶ 1:37:57Sec. Collins: That is not it and we will work to get you the information.
▶ 1:38:02Sen. King: When?
▶ 1:38:03Sec. Collins: We are working through it now.
▶ 1:38:06Sen. King: How about next friday?
▶ 1:38:08Sec. Collins: I will see what we could get to you.
▶ 1:38:12Sen. King: That is not very satisfactory. A list of 580 five contracts, somebody has that. When you were confirmed, senator blumenthal said will you commit to respond promptly to members of this committee who request information and be only transparent? You said that is my intention. You will have every information that you need.
▶ 1:38:40Sen. King: This is the antithesis of transparency. I can't imagine anything more simple. Let me go on to another question. There has been a lot of questions today about the firing. What bothers me is the goal. If you are trying to restructure the v.a., should we talk about not starting with an arbitrary number, how did you choose 2019 as the target for your staff?
▶ 1:39:15Sen. King: What is magical about that year?
▶ 1:39:16Sec. Collins: Going through downsizing the government, making it the determination from looking at his team percent as we look at the target.
▶ 1:39:29Sen. King: If you have an arbitrary number whether it is 50% or 2019 that presupposes the result that there are that many unnecessary job. It seems to me you will do an analysis of where is it? I am not one who's advocating in any way that the v.a.
▶ 1:39:48Sen. King: Was perfect on january 20, 2025, the staffing should be examined, policies, in particular the red tape that senator tuberville was talking about. Those are all things that should be examined. It should be done in a thoughtful and transparent way. I don't understand why the magic .
▶ 1:40:14Sen. King: 2019 there have been seven significant veteran related bills including the pact act, one of the most significant expansions of v.a. Benefit in recent history. The goal is going back to that particular year. The goal should be efficiency.
▶ 1:40:35Sec. Collins: One of the things you look at just last year, the previous administration improved presentation that they made and advocated for a 28,000 person decrease in employees at the v.a.. It is not a new thing to look at. We are looking at this in a way that says what is the best art?
▶ 1:41:05Sec. Collins: There's also a newer technology, ways that we could get stuff done. That is the efficiency issue we are talking about.
▶ 1:41:15Sec. Collins: In the memo it says there is an information gathering report due march 10. Another due april 10. There is a departmentwide review completed by may 9, three days from now. Will you share that data with this committee whose responsibility is to oversee the implementation of the laws and regulations on behalf of veterans?
▶ 1:41:43Sec. Collins: Those are being worked on. We have an extension because our department is so large. We are not making these quick decisions moving forward on that.
▶ 1:41:57Sen. King: I will end with this, the reaction to the contract seems to be so straightforward doesn't fill me with confidence that we will have a transparent relation ship here. We are on the same side. We want the whole goal of everybody stated here today to protect veterans and make sure they get the services that they earn.
▶ 1:42:20Sen. King: To the extent you could work with us and allow us to understand what you are doing, that would be helpful to develop a more collaborative relationship.
▶ 1:42:31Sen. Boozman: Thank you Mr. chairman, thank you for being here set. The v.a. Owes it to the veterans it serves to provide them with the best possible experience. I appreciate your commitment to improving veterans health care and benefits and improving the veteran experience. We appreciate your hard work to get that done.
▶ 1:43:00Sen. Boozman: I want to thank you for submitting a 2025 spend plan in a timely manner. It raised some questions with the appropriations committee. None of those questions have been answered with request for briefing on the plan not getting any results.
▶ 1:43:22Sen. Boozman: As we are trying to get our appropriations bills done, will you commit to sending a team over with us as to what is going on and give us a little bit more detail?
▶ 1:43:37Sec. Collins: We will be happy to do that.
▶ 1:43:41Sen. Boozman: That was easy. 2025, 20 26. It proposes a reduction in the v.a.'s I.t. System. The review of the 1000 unique systems of the v.a. Is not completed yet. Would you consider balancing your proposed reduction to get that report done to see what they find as dated?
▶ 1:44:10Sec. Collins: We will work with you as we go forward on that.
▶ 1:44:18Sen. Boozman: You recently introduced the ending of the v.a. Service row graham, that's on the v.a. Take on modified home loan -- service program to avoid financial risks the v.a. Has exposed the agency to. We are worried about the current population.
▶ 1:44:43Sen. Boozman: It is my understanding that as of may 1, they are now at risk of foreclosure. Now that it is unavailable, how does the v.a. Plan to help veterans at risk of sec.
▶ 1:44:57Collins: Sec. Collins: or closure? -- of foreclosure?
▶ 1:45:02Sec. Collins: Is this an area we need to be in? Those are the kind of things the decision there was the people that have more appearing to be a larger burden. We will be working as I said earlier, we are looking at it from a perspective of legislation being talked about with partial claims that could help them in the long term.
▶ 1:45:33Sen. Boozman: It is one thing going forward. It makes it really difficult. How did the v.a. Make the decision to reduce the v.a.'s remote temperature monitoring with clinical benefit and cost savings?
▶ 1:45:51Sec. Collins: Could you repeat the question.
▶ 1:45:57Sen. Boozman: The recent changes have impacted remote temperature monitoring programs. As you may be aware this program is critical in preventing what is required because it has another diabetic foot complications. They result in significant cost savings for the v.a.. Are you aware of that? If so, how did we come to that conclusion?
▶ 1:46:25Sec. Collins: I will have to get back to you on that one.
▶ 1:46:32Sen. Boozman: I understand. You have a lot going on. During your remarks at president trump's april 30 cabinet meeting you mentioned the potential of researching psychedelics as an effective tool for mental issues, could you provide further details on how they plan to take action on this?
▶ 1:47:03Sec. Collins: I'm committed to doing whatever we can to provide veteran and maybe those who have not -- it leads to a lot of what we have seen in suicide and death by suicide. We are looking at 11 studies going on. Most are performed outside the v.a.
▶ 1:47:29Sec. Collins: I side program at every university, single treatment and followed up by two weeks of intensive counseling that has lowered the score number. I have said this with hhs and others, to make sure we are not closing off any outlet for a veteran who could be helped by these programs.
▶ 1:47:58Sec. Collins: We will be working with congress on that.
▶ 1:48:02Sen. Sanders: Thank you. Secretary collins, the workers in the united states have the right to be in unions. Secretary collins yelled due workers in the united states have right to opinions? -- to be in unions?
▶ 1:48:26Sec. Collins: Yes. I didn't know it was a question.
▶ 1:48:33Sen. Sanders: President trump issued an executive order banning collective bargaining eliminating union rights to 79% of workers. Do you think workers in the v.a. Are a threat to national security if they are a member of a union? Of a union?
▶ 1:48:52Sec. Collins: I don't think that was the issue. It was about a national security interest of our fourth amendment. It was about making sure the fourth amendment.
▶ 1:49:08Sen. Sanders: Is a nurse a national security threat by being a member of a union?
▶ 1:49:12Sec. Collins: It is not the fact that the v.a. Is a national security threat, it's a threat if we can't perform our fourth amendment.
▶ 1:49:24Sen. Sanders: Bottom line is unions, 79% of workers, they no longer are able to engage in collective bargaining. That is an outrage.
▶ 1:49:37Sec. Collins: At this point that is not true.
▶ 1:49:43Sen. Sanders: Let me ask you this, do you believe every veteran in this country as I believe, are entitled to v.a. Health care?
▶ 1:49:52Sec. Collins: As a veteran, yes.
▶ 1:49:55Sen. Sanders: What are you doing to improve outreach to bring more veterans into the v.a.?
▶ 1:50:04Sec. Collins: That goes back to the question you distaff. Does everybody have the right? Yes. I cannot force them in. I may have missed the point, I apologize.
▶ 1:50:20Sen. Sanders: There are a lot of veterans who do not know what their benefits are. It is our obligation to say to veterans all over this country put your life on the mind -- line, we welcome you to the v.a. If you choose to come in.
▶ 1:50:37Sec. Collins: This is a great place for us to have an honest conversation. Part of this goes back to how we are transitioning, I think that is one of the facts. There's an honest conversation, is it properly placed right now? We are doing outreach all the time to let people know.
▶ 1:50:59Sen. Sanders: I think we could do a better job.
▶ 1:51:01Sec. Collins: I agree.
▶ 1:51:03Sen. Sanders: We talk about v.a. Health care, we don't put an end to the complex. We are living in a nation that has a broken, dysfunctional, wildly expensive health care system. In your judgment, how does v.a. Health care compared to health care in the regular world for civilians?
▶ 1:51:29Sec. Collins: In certain areas you have some hospitals performing exceptionally and some that are not. This is something I said earlier we cannot separate the v.a. From the health care system as a whole. Sometimes we do that.
▶ 1:51:51Sen. Sanders: My understanding is we have roughly speaking a shortage of 2500 doctors, 6600 versus. What are you guys doing to bring in more doctors, nurses, social work into the v.a. Where they are desperately needed?
▶ 1:52:11Sec. Collins: I want to move them into patient care. I would like to have help from the congress as well. We need to look at our pay structures and caps on what we could pay them. Sometimes hundreds of thousands of dollars less.
▶ 1:52:32Sen. Sanders: I agree. You acknowledge that right now there is a shortage of doctors, nurses, social workers?
▶ 1:52:40Sec. Collins: There is a shortage of everybody on the health care issue.
▶ 1:52:46Sen. Sanders: I'm not criticizing.
▶ 1:52:48Sec. Collins: We are the same as every other health care system. That is something we are constantly in outreach about.
▶ 1:53:03Sen. Sanders: The department of defense has a medical school. You are aware of that? It does a very good job. Do you think one of the problems we have overall is that we are not graduating enough doctors and nurses in america?
▶ 1:53:21Sec. Collins: Yes.
▶ 1:53:25Sen. Sanders: Do you think we could be expanding schools like the uniformed services medical school to bring more people into dod and v.a. Health care?
▶ 1:53:35Sec. Collins: It's an interesting concept. Why are more of our young people not going to school to be a doctor or nurse.
▶ 1:53:44Sen. Sanders: Fair enough, that has to do with I'm a working-class kid, I will graduate medical school $500,000 in debt, the idea of entertaining programs, you want to go to medical school, we will pay for your entire tuition to encourage you to get to medical school.
▶ 1:54:06Sec. Collins: It is possible you have that when you could pay for your medical school. It's an overall health care, you and I'd probably agree with this probably more than anything that we have two make sure the pool of workers is adequate for all of our systems, not just the v.a. To make sure it is an issue we have right now. It is a bigger discussion. I appreciate you bringing it up.
▶ 1:54:37Sen. Cramer: . I was encouraged by that. Welcome. It's a good thing we haven't been here all day. I want to raise an issue, we just passed under the first trump administration, under the biden administration we made it a law specifically that senator
▶ 1:55:08Sen. Cramer: Sanders was raising about how do you inform veterans more about the opportunities that they have at the v.a.? I would encourage you to look at that and make sure we are managing that well. With regard to the workforce, it is true, we have a shortage of people in health care everywhere.
▶ 1:55:36Sen. Cramer: At the same time, a north dakota example and senator blackburn spoke to it at the end of her questioning. A north american continent that is 350 miles, 200 miles up and down. There are 36 critical access hospitals in rural communities.
▶ 1:56:05Sen. Cramer: In north dakota where the only va hospital is it is 412 miles. It takes roughly six hours in 19 minutes if you don't stop to go to the bathroom. There are these 36 critical access hospitals that have 26 hospital beds each and maybe two or three of them are being used at any given time. Senator blackburn talked about community care.
▶ 1:56:34Sen. Cramer: We talked about shortage of facilities, workers, yet there is all of this infrastructure not being used. There has to be a way to utilize this and actually save money to create opportunity for the struggling hospitals.
▶ 1:56:53Sec. Collins: I don't disagree at all. They had this conversation a long time ago that we could actually do this. I think it is a great idea. One of the things is how we utilize the possibilities to make sure we are getting people there. This is found not only in our facilities but community facilities, it is an issue called care.
▶ 1:57:24Sec. Collins: Our doctors seeing enough patients? That's why I have already been looking at several options. I'm encouraging everyone of our facilities to the understanding and agreements with local hospitals so they could go back and forth. It is a big issue.
▶ 1:57:51Sec. Collins: We have underutilized hospitals, facilities, one of those we are looking at in jacksonville, florida that we could save our community care hospital. There's a lot of things we could work on here. Using all of the resources that we have.
▶ 1:58:12Sen. Cramer: We should look for opportunities for winners and winners. Congratulations, thanks for doing that. You have been battered about it. Without this technology being an issue. I will stick with a lower number . Correct me if I'm wrong.
▶ 1:58:39Sen. Cramer: I believe there were 52,000 new positions added between 2021 and 2024, does that sound about right? 52,000?
▶ 1:58:48Sec. Collins: Yes.
▶ 1:58:52Sen. Cramer: How has that improve the health care offerings? Are we seeing a lot more? Is there better care? That 52,000, has that saved the day for our veterans?
▶ 1:59:04Sec. Collins: I don't think so. I use it in a different way. If you go back to 2015 when we were put under high-risk, looking at this, I'm using the numbers we have given. I'm using the numbers we currently have at the v.a., they all rose. It is a 260,000, $220,000 now.
▶ 1:59:39Sec. Collins: At 10 years ago, if I had to tell this committee, this is careers and political. If I told you in 2025 you will have a budget of almost $400 billion, you would have thrown a party, everything would have been great. 10 years later we are still experiencing the same thought.
▶ 2:00:09Sen. Cramer: That is the important point. Everybody on this committee wants to have an honest discussion about how they do better for our veterans and real data could help us. Plenty of data to tell us where we have been. Thank you.
▶ 2:00:30Sen. Duckworth: I do think it's important to acknowledge that we did in just the first year of the pact act alone, that increase is to deal with that increase in veterans coming into care long overdue.
▶ 2:00:50Sec. Collins: We lost about 400,000 veterans that year as well. When you testified before this committee in january you ted -- said it would be a market failure if a veteran must contact the congressional office with access to the v.a. Care and benefit. My office alone received 143 requests since the start of the trump administration.
▶ 2:01:20Sec. Collins: A consequence as they went through the critical program serving our nation's heroes. A vietnam veteran did not receive his benefits due to greater than usual processing time. A veteran in urgent need was told the earliest available appointment was six weeks away. A veterans window and cancer survivor had their prescription canceled without notice forcing her to pay $700 out-of-pocket.
▶ 2:01:52Sec. Collins: Applying for benefits was met with a 6-12 month backlog. They were there when I was at the v.a. During the obama administration. I would agree this is indeed a market failure. We want to overcome this backlog.
▶ 2:02:15Sec. Collins: This will require an immediate reinstatement of employees that they failed to evaluate on the basis of merit. They failed to use a scalpel and instead chose the most wasteful, inefficient and lazy path. Simply firing probationary employees in mass.
▶ 2:02:45Sec. Collins: Those probationary employees who signed up since the pact act was passed. Most americans including thousands of veterans make the patriotic decision to serve their country. Will you commit to reviewing the status of all terminated v.a. Employees and promptly reinstating them and pushing them against indiscriminate mass firings?
▶ 2:03:06Sec. Collins: Most of the ones under probation were already brought back to work. We will keep looking at our set up. We have over 300,000 plus positions that were not -- they protected those in the disability care. I appreciate your concern.
▶ 2:03:37Sec. Collins: You brought up something very close to the heart, that veteran who was given six weeks for an appointment, where they given a community care option?
▶ 2:03:44Sen. Duckworth: We will have to get that information.
▶ 2:03:47Sec. Collins: I want to help when we can. I have acknowledge this since day one. The calls to our v.a. Represent something we are not doing right. That should overlay everything we are talking about, why is this a problem? I'm assuming that's probably a dod issue.
▶ 2:04:19Sec. Collins: They are not done.
▶ 2:04:21Sen. Duckworth: Let me go on to the next thing. In tammy baldwin's oversight letter dated april 7, 2025. They received termination notices, all terminated employees who were reinstated have been rehired to the same positions they held.
▶ 2:04:46Sen. Duckworth: While I appreciate your candor in acknowledging the fact that employees were terminated and confirmed this was incompetence and not malicious intent, I hope you recognize your work in fixing this mistake is not complete. I have one veteran who you still have failed to reinstate. This was a person who did so well they were promoted to help train other vcl hotline employees.
▶ 2:05:19Sen. Duckworth: They still have not been reinstated. The veterans crisis line serves in our responsibility to make sure it is with our highest standards just as every military commander understands the lethality depends on a diverse network of enablers with capacity. You can't just invest and rehire the pilots of the aircraft and not retain the refuelers and mechanic to fix that aircraft.
▶ 2:05:48Sen. Duckworth: Do you agree that support staff were trained to handle the basic programs that are mission-critical?
▶ 2:05:57Sec. Collins: That is probably walking back. We have to clarify here, it is clarified by career employees. They talk to our veterans, none of them were let go.
▶ 2:06:13Sen. Duckworth: They cannot operate. You are parsing your words. There are people who have been fired who have not been reinstated. These are people who are training the people. People who did so well that they are the supervisors, you can't just say we will take care of the pilots but not the mechanics.
▶ 2:06:39Sec. Collins: We could find common ground agreement that this is why they were brought back. It was given that people were not being answered on the call line. Many times in the press, that is not true. I acknowledge the fact we brought back staff. That is why they are now exempted.
▶ 2:07:04Sec. Collins: We did not -- I would not also let it be put out there that people were not getting phone calls answered because those were the ones that were let go. We need to be honest about the situation as far as I agree with you. Please let me know, let my office find out.
▶ 2:07:22Sen. Sullivan: Thank you for your testimony today. Might want to take care of our veterans. You and I have talked about it. One of the biggest issues I have seen, one of the biggest scams I have seen in terms of hurting veterans was the camp was june at camp was june marines exposed
▶ 2:07:56Sen. Sullivan: To toxic water. I work with my colleagues on the other side of the aisle four years to try to get them to cap contingency fees to the lawyers who are advertising billion's of dollars on fox news and cnn, none of my colleagues would do it. Why? We know why. Everyone of them knows why.
▶ 2:08:24Sen. Sullivan: These law firms were charging 60% and 70% contingency fees to steal money from sick marines. That happened. I asked a woman about it she said I'm paying 40% from some ripoff law firm. I tried to get my democrat colleagues, the former chair who is no longer here.
▶ 2:08:55Sen. Sullivan: Favoring trial lawyers over veterans. We talked about taking care of veterans, I get a little miffed when my colleagues bring the show and they would not do it. You know was doing it? You are doing it. Thank you. You put out a scam alert saying if you are getting charged over 25% by a law firm. The attorney general, president biden, work with me to put that 25% cap. My colleagues wouldn't do it.
▶ 2:09:27Sen. Sullivan: It's a little rich when I hear everybody talk about taking care of veterans and I spent a decade trying to get democrats to help me and they never did. I want to thank you for that. There are still law firms who fund democrat campaigns who are charging marines and families 60% and 70%.
▶ 2:09:51Sen. Sullivan: Could you continue to work with me to put out scam alert so these patriotic marines and their families and sailors, this is zero-sum. You get $1 million, it will either go to the law firms or to the marine. I know what side they were on and the former chair of this committee was on. You are on the side of the veterans. Thank you.
▶ 2:10:18Sen. Sullivan: It's a little rich for me to watch all of this theater when I know you are taking care of it. I appreciate the scam alert. I'm still seeing these ads on tv. My staff calls these law firms, 70%. The biggest adjustment -- injustice I have seen, ripping off sick marines and families. Nobody on the other side of the aisle is helping. I haven't worked this hard on any other issue since I have been here.
▶ 2:10:50Sen. Sullivan: Thank you very much for the scam alert. The former attorney general said if you are charging a sick marine more than 25% it is a criminal violation. Attorney general bondi will bring it, criminal. Civil violations if they go over 25% if they are just doing the administrative filing. Thank you.
▶ 2:11:14Sec. Collins: I appreciate that and I will work with anybody on this committee. If you are doing something that shouldn't be done, I take this personally. We could disagree about things, numbers, anything else. At the end of the day, I want to say I believe all of us are trying to get the veterans help. When you have firms that do that we will put the scam alert, they could get mad at me all they want.
▶ 2:11:45Sen. Sullivan: They could get mad at me, I don't care. It is the right thing. Everybody knows it. Let me thank you on another thing, every hearing, I have been talking about the alaska backlog. It is a proud heritage of the great state of alaska.
▶ 2:12:11Sen. Sullivan: The previous administration, the backlog to just get an appointment ballooned, it was almost 15,000. 15%. It finally went down. 5500 at the end of january when the biden administration left. You 1000 300s 61.
▶ 2:12:45Sen. Sullivan: -- 1000 300s 61. In three months more than a ended in four -- in four years through the alaska backlog. That real service for our veterans. Judge collins thank you.
▶ 2:13:08Sen. Sullivan: I know it is an issue you and I have talked about. This will bring the backlog down even further. I will submit questions for the record that relate to community care and some of the other issues you are working on. On both these issues , I appreciate your focus. This is what taking care of veterans is. Breaking down the backlog and making sure our marines and sailors are not scammed.
▶ 2:13:43Sen. Sullivan: >> chairman, thank you for holding this hearing. It is a bipartisan goal to support our veterans. This is one of theirst hearings I have had were after the confirmation hearing, you brought the secretary back in short order. I appreciate that.
▶ 2:13:57Sen. Sullivan: Terry collins, during your confirmation hearing you assured me and the others here that the mission is the veteran and "he would not sacrifice the veteran." I took you on your word as did many on this side of the dais. Since you have taken office, you moved to terminate v.a. Contracts, offered to buy out v.a.
▶ 2:14:21Sen. Sullivan: Employees that were in already a shortage situation in those career fields. 2400 recent v.a. Hires were let go. And because of the courts I think brought back. You have been here today doubling down and tripling down on that. I have no problems with cutting sat in the v.a..
▶ 2:14:49Sen. Sullivan: I worked for the defense department. If somebody said to me, cut fat I know where I would cut. It is the nature of the cuts. If you are firing somebody on friday and they are brought back on monday no ceo in america would be lauded for those kind of sloppy cuts. Then you came to howell, michigan in the last month and I have asked directly about the potential for 80,000 additional employees to be cut.
▶ 2:15:19Sen. Sullivan: And instead of pushing back you said there would be a lot of friction. I understand your wordsmithing things to say that no nurses or doctors in the v.a. Facilities will be touched. That's good. But I held a roundtable with veterans, folks in the business and their concern was if you are a veteran and you walk into the v.a. In iron mountain and you need to get a claim.
▶ 2:15:47Sen. Sullivan: You put in a claim to get knee surgery and there are no caseworkers, there is no people working on the claims, then it takes you two years to get an answer, that's also not access to care. Doctors and nurses may be there, but if you cannot go in, if you are in pain every day, that's a problem. It's a problem for veterans center staff, primary care administrators, I.t. Staff. I know it is wonky but you have just etc.
▶ 2:16:16Sen. Sullivan: To the electronic health record transition. I.t. Staff are important if we are going to make sure we don't lose records of veterans and then benefit claims administrators, all people who do not meet your criteria to be saved. We all want to serve the mission of the veterans. What was really strange was we had the deputy chief medical officer up here for a hearing and we said, what is the plan on cutting potentially 80,000?
▶ 2:16:46Sen. Sullivan: Have you been consulted? They said, clearly, no. So I am having a problem understanding how I am to believe that veterans will get the same or better care that we want when you seem to be claiming these 80 south and are like d.e.I. And interior designers. There is no way all 80,000 are in those job fields. Help me understand.
▶ 2:17:17Sen. Sullivan: How will you preserve the veteran who needs knee surgery but there is nobody to process his claim?
▶ 2:17:21Sec. Collins: There is a lot to unpack there. Yes, the mission is the veteran. Earlier you said you have worked in dod. If you worked at v.a. You would probably be able to do the same thing.
▶ 2:17:39Sen. Slotkin: 80,000 is different. Any ceo in america that fires people on a friday and rehired them with back pay a week letter -- later would be fired from their job. It is sloppy and you know it.
▶ 2:17:57Sec. Collins: I disagree. When you look at these issues, it is interesting to me. Just playing the scenario out if you go to dod, is 20,000 the proper number, 50,000, 10,000? At the v.a. We exempted over 300,000 positions.
▶ 2:18:19Sen. Slotkin: How come there were people fired then rehired from the veteran suicide hotline? You acknowledged, even publicly, that some of these things were a mistake. It does not give confidence that an 80,000 number, you did not take a real pharaoh -- career fields. You just said 80,000. That that is being done with a scalpel, not a sledgehammer. For veteran care, it is not only me asking these questions.
▶ 2:18:46Sen. Slotkin: It is veterans with a very different political view than me getting seriously agitated back home. I do not understand the logic behind a cross. -- behind across-the-board haircut.
▶ 2:18:59Sec. Collins: This whole time I have had to fight against this idea. If all they hear from people is if you cut this it will impact my health care, what will they think? They have not seen a plan. We are still working a plan. I won't play out a plan in public.
▶ 2:19:22Sec. Collins: I know I am over. But it is playing out in public because you have fired people and they have been rehired. That's not a secret plan. People not -- in my district, marines, veterans have been fired from their v.a. Jobs and brought back. It's not a sneaky plan. You are in it, letting it, living the sloppiness of it. My time is over. I cannot agree to 80,000 will be a nice trim scalpel approach.
▶ 2:19:53Sen. Banks: The president's budget calls for a nearly $500 -- $500 billion increase for the v.a., primarily for medical care and homelessness. You have been accused of cutting care and benefits. We heard a great deal of that today. It is clearly a scare tactic. How do you plan to target the new funding?
▶ 2:20:16Sec. Collins: Exactly what you just said. Adding this to our health care and community care side. Community care is growing but has been under budgeted in the last few years by previous administrations. We have to make sure that the proper moneys are being put into community care. Also, looking at how we need to improve our direct care services. We have a lot of issues out there. They range from not only recruitment and retention of employees, but also our facilities. The average age of our facility is well over 60 years old.
▶ 2:20:47Sec. Collins: These are the kind of thing that we are working on now. Again, along with reshaping, looking at our contracts to make sure that some of the folks sitting behind me actually get the care they deserve and have earned. It is interesting me -- to me, when we talk about the last little bit, some of the conversations I have had today were people that called the offices saying they had deployments that are delayed. In all fairness, I have to ask, the same thing was happening in december. The same thing was happening in november last year.
▶ 2:21:20Sec. Collins: The only difference now is I am sitting here saying, we are looking at going through a comprehensive approach on how to support the size of the force at the v.a. And spend the money that you enter house appropriate us -- that you and the house appropriate us. That is the only difference. Veteran after veteran standing here saying I could not get in to see my appointment. The problem is, when was that? We are still working on that. We have issues in the system. The bureaucracy isn't good.
▶ 2:21:51Sec. Collins: We have hospitals and v.a.'s not sending people to community care.
▶ 2:21:55Sen. Banks: Cutting bureaucracy means better service for our veterans and that is what you are doing. How do you plan to reinvest any savings from headcount reduction to improve services for veterans?
▶ 2:22:05Chair Moran: We have to go back --sec. Collins: we have to go back taking it to community care, improving our I.t. System, improving our prosthetics, improving our situations with art mental health counselors and others. So we can actually show real results. One of the things that has been amazing that has not been talked about here today which, for me, has been topline all along, except, in a way that was frankly not truthful in the sense of what we are doing.
▶ 2:22:35Chair Moran: Suicide has not been discussed here today. The issue we have had since 2008, we have not seen a significant decrease in veteran suicide rates. Though we expend literary -- literally billions of dollars on that. We have talked about other kinds of care. How can we tap into research into psychedelics or other things working with cso's and nonprofits to make the difference here? This is something we have to have.
▶ 2:23:04Chair Moran: Sometimes, we get caught up in the overall scheme of the v.a.. Believing the v.a., unfortunately, being on the hill, is something that is -- manipulated in a certain way that is special. We are special in the sense that we get to treat the veterans of the united states. That is the most precious gift we have. But we are not unique.
▶ 2:23:24Chair Moran: We experience the same issues as all of health care and we will make sure, like every other health care organization goes through this reorganization of their facilities, they could do the same thing.
▶ 2:23:36Sen. Banks: I appreciate your focus on that, very much. Go back to the reduction in force. How much do you expect the reduction in force to be retirement or early retirement versus separation?
▶ 2:23:49Sec. Collins: We are seeing a good bit of that now. That is one of the things -- I got accused of that with the cuts we had, that somebody had not been able to get their next appointment and the doctor had actually just retired out. They just needed to bring in a new doctor. That's not a reduction in force. That is a simple matter of attrition in hospitals. Some of that will be taken care of.
▶ 2:24:14Sec. Collins: Some of them have taken the early retirement option, a program which I think has worked and done a great deal. Some of that will be normal attrition like that, and also, incentivized attrition.
▶ 2:24:26Sen. Banks: I want to ask you, very quickly, reviewing the situation, the biden administrations 2020 five budget was misleading, as you know. -- 2025 budget was misleading, as you know. Congress closed the immediate $6 billion shortfall in march, but there are -- are there still budgetary problems to clean up?
▶ 2:24:48Sec. Collins: That is what we are trying to work through now. I promised in my confirmation hearing -- and I think you will remember -- I think you and I had this conversation. I was not going to come to the committee or even send you information. I could not get you the information because it was not ready yet or we weren't comfortable with the numbers. The same thing applies to a lot of the questions I have gotten here today. As we move through the process we will make sure we give the information. We are working through a budget process now.
▶ 2:25:19Sec. Collins: I think that is why the president and his budget, which is a very favorable to the v.a. Are looking at what we need to do is something we can then build on as we go.
▶ 2:25:29Sen. Banks: Thank you.
▶ 2:25:34Chair Moran: Senator blumenthal and I will have another round. Senator blumenthal is committed to five minutes. I have a constituent weighting in the back room. I will be back in five minutes. I have a couple questions for you and then we will conclude the hearing. Senator blumenthal.
▶ 2:25:52Sen. Blumenthal: Secretary collins, you just told senator banks you will give us the information that you have. You have failed to give us the information that you should have. Or that you do have and you are declining to give us. You are declining to provide any numbers of specific categories of people whom you planned to fire. The contracts that you have canceled or that you plan to cancel.
▶ 2:26:21Sen. Blumenthal: I will ask you to provide that information in written form. I won't get into an argument with you here. I think a good portion of the questions you have been asked, frankly, you just have not answered. And I am hoping you will provide those answers. Let me tell you one fact that I think we do know. That is that your goal is to fire 15% of the v.a. Workforce.
▶ 2:26:53Sen. Blumenthal: You have said that again and again and again. I will ask a list of your quotes be put into the record. Most recently, to the arizona public media acpm on may 1 that "I said there was a goal of 15%.
▶ 2:27:16Sen. Blumenthal: If you do the math, that is about 80,000." what I take away is you have a goal of slashing 15% of the workforce come hell or high water and you will figure out whom to fire as you go along. That means frontline people to have been hired among those 50,000 people or 80,000 people.
▶ 2:27:46Sen. Blumenthal: I have a list which I will also ask be entered into the record. For example. 18,000 registered nurses. 5000 social workers. Increases of 20% and 25%. These are frontline people. The total number is approximately 17% increase in the v.a. Workforce.
▶ 2:28:17Sen. Blumenthal: Schedulers, physicians, pulleys, psychologist, registered nurses, social workers, and a 31% of them are vba. If you fire those people, and your goal is to fire 15% of the total workforce, there among them, you will lose quality. You will lose time. There is no way around it. Now, I welcome your commitment that the savings that you just told senator banks about will go into care for our veterans.
▶ 2:28:45Sen. Blumenthal: But that is not what you said on april 17. You said "that will be up to the president." now, I do not know which is true. But, I hope that the savings will go into caring for veterans. But is that your commitment now?
▶ 2:29:08Sec. Collins: I would like to see the context of that quote and where it was actually put. I think the issue here today is look, senator, it is not right to stand here today -- because I actually think it was a quote from others. I won't say who specifically. Others said we would take 50% of doctors, 15% of nurses. That is wrong. It is almost cruel.
▶ 2:29:38Sen. Blumenthal: It would be cruel if it happened.
▶ 2:29:39Sec. Collins: It's not happening. If you were going to reorganize your office would you stand up and say, here are the 16 people we are discussing now?
▶ 2:29:53Sen. Blumenthal: These are your words. On 2 -- in tucson on april 30. Script news, april 20 one, spectrum, local news, april 9, detroit free press, april 1, collins told the veterans cutting 80,000 people from the department is a goal.
▶ 2:30:12Sec. Collins: What are we doing here, senator?
▶ 2:30:17Sen. Blumenthal: 15% is a goal. Let me go on for the record is there.
▶ 2:30:20Sec. Collins: Nobody is denying you, senator. I'm not sure the point you're trying to make. I have said it is a goal but it also may not get to that number. It is the process we are going through. I won't walk -- work out a process in front of a committee or anywhere else where we are still under the deliberative process because at the end of the day.
▶ 2:30:39Sen. Blumenthal: The gold -- gold.
▶ 2:30:42Sec. Collins: It's mild practice for me to do so in front of the committee. I will do so to scare people. We will make sure our health care is provided for and people are getting disability benefits. What you are seeing now, whether you agree with the numbers are not. That is the part we cannot get away from. I am looking for anyway to do that.
▶ 2:31:05Sen. Blumenthal: You responded to senator sullivan's question about capping certain attorney fees for the camp lejeune victims. Are you aware of the ensuring justice for camp lejeune victims act that senator tillis and I have offered that would put caps on attorneys fees?
▶ 2:31:26Sec. Collins: No emma but it should have come a long time ago. -- no, but it should have come a long time ago.
▶ 2:31:38Sen. Blumenthal: Will you support the legislation?
▶ 2:31:39Sec. Collins: Why wouldn't senator sullivan be on that bill?
▶ 2:31:44Sen. Blumenthal: You know what --
▶ 2:31:45Sec. Collins: I'm just curious. I won't let veterans be duped into paying --
▶ 2:31:55Sen. Blumenthal: Maybe talk to senator sullivan regarding the bill. I am asking for your support.
▶ 2:31:59Sec. Collins: I will take a look at the bill and using when we knew.
▶ 2:32:06Sen. Blumenthal: You are doing a scam that already eyes and just maybe the way to really help veterans is to support --
▶ 2:32:12Sec. Collins: Do you deny this is happening? If not -- I mean -- you are asking me to support a bill I have never read.
▶ 2:32:23Sen. Blumenthal: I don't want to take any more time here he seems to feel he is asking the questions here. But I am happy to continue the conversation.
▶ 2:32:33Chair Moran: The secretary said he will take a look at the bill. If the bill you don't know anything about so you can't say whether you are for it. Senator blumenthal is happy to have your support after you look at it.
▶ 2:32:47Sen. Blumenthal: Let me ask you, secretary collins, a couple quick questions for you. Will you commit to provide privacy for telehealth professionals doing mental health care?
▶ 2:33:00Sec. Collins: We have already done that, sir. Anything in our return to work policy indicates if they are put into a position where they don't have policy it is against the policy of return to work.
▶ 2:33:13Sen. Blumenthal: Do you deny the accuracy of the new york times?
▶ 2:33:16Sec. Collins: Very much so. All of the reporting was our systems were working. We asked veterans, if they were affected by that. They could not produce a single one. The new york times produced overworked, crowded conditions. They sent our press people to empty rooms. Yes, I deny that. >> can you provide us a factual reputation? -- refutation.
▶ 2:33:48Sec. Collins: Yes. I take each one of these seriously. Pro-public, new york times. We answered them one by one by one. I have the email chains with the reporters that they choose to ignore. That is what we get.
▶ 2:34:07Sen. Blumenthal: I welcome you are committed to providing privacy and will provide a line by line refutation. Of the new york times. When you do the same with pro public appeared -- will you do the same with pro publica?
▶ 2:34:23Sec. Collins: I would do the same for that as well.
▶ 2:34:27Sen. Blumenthal: Have research contracts been canceled or frozen?
▶ 2:34:32Sec. Collins: The ones continuing are still continuing. If they were running out we are on a 90 day policy to see if they need to be continuing.
▶ 2:34:40Sen. Blumenthal: Is that a yes?
▶ 2:34:40Sec. Collins: I can't answer the question any better with that. They do run out after a three year cycle.
▶ 2:34:50Sen. Blumenthal: So you have not canceled any?
▶ 2:34:53Sec. Collins: Not that I am aware of in that situation. If you want to provide something.
▶ 2:35:11Sen. Blumenthal: Is medicaid important veterans? -- important to veterans?
▶ 2:35:17Sec. Collins: Give me the context.
▶ 2:35:21Sen. Blumenthal: Do veterans take advantage of the medicaid program?
▶ 2:35:24Sec. Collins: It is a conversation that has been going on a while now about medicaid advantage plans.
▶ 2:35:30Sen. Blumenthal: I'm talking about medicaid not medicare advantage.
▶ 2:35:33Sec. Collins: Sorry.
▶ 2:35:36Sen. Blumenthal: You don't know. Veterans use medicaid and you aren't aware of that?
▶ 2:35:43Sec. Collins: I am not sure what your question is.
▶ 2:35:48Sen. Blumenthal: Is medicaid important to veterans?
▶ 2:35:52Sec. Collins: It is important to everyone who uses it.
▶ 2:35:57Sen. Blumenthal: Thank, Mr. chairman.
▶ 2:35:59Chair Moran: Jarablus -- senator blumenthal, thank you. A couple wrapped up from me, Mr. thank you -- Mr. secretary. What are the facts with the veteran hotline?
▶ 2:36:18Sec. Collins: We protected all those that actually answer the phone. I saw it coming up in the press that we fired and the ones actually answering the phones. That's not true. We found there were some staff that were let go. I made the decision to bring everybody back in to protect the entire group. We did not want anybody to falsely accuse we were not answering the line.
▶ 2:36:47Chair Moran: Today, it's the crisis hotline any more or less personnel that it was before this?
▶ 2:36:55Sec. Collins: I think it is the same.
▶ 2:36:57Chair Moran: The people let go?
▶ 2:37:00Sec. Collins: They are back.
▶ 2:37:02Chair Moran: You answered my question about your interest in the ig. You believe in its value. Would you also ask the white house for an ig for the department?
▶ 2:37:13Sec. Collins: We already have.
▶ 2:37:14Chair Moran: Mr. secretary, those are my questions. I often ask the witness as if they have anything they want to clarify or correct.
▶ 2:37:23Sec. Collins: Look, I appreciate it and I appreciate the ranking member. We have the same goals. We will disagree. We will disagree about how to go about it. But, there are several things I won't do and I do not think it is fair to veterans to take things that were leaked and designed to disrupt. They were designed to make the v.a. Look bad or make veterans scared and I won't do that.
▶ 2:37:53Sec. Collins: I will challenge anyone that will hurt or scare our veterans or employees. We will give you everything we can at the time and I promise you that. We have had conversations, you and I. But when we are doing something as large as we are in an organization as sensitive as the hill. It would not be right for us to do that in public. It would not be right for us to come say here is everything we've got. I did and it might not be the final decision.
▶ 2:38:20Sec. Collins: We will come to the best possible decision we can for the veterans in this country so they have a v.a. System that actually works. When we understand that -- again, the v.a. Has been an issue for a long time and we are trying to make it not be an issue anymore. We are trying to get it to a point where it is doing what it is supposed to, taking care of veterans. I appreciate being here today.
▶ 2:38:43Chair Moran: I encourage you to see if our crew can answer our team, both the minority and majority staff set -- questions fully and promptly.
▶ 2:38:52Chair Moran: Can I say one thing about that? Since I have been in about 90 days we have answered for ranking member blumenthal, third -- 78 rfi's, 11 briefings, nine technical assistance calls, four technical assistant three progress and many visits. We have answered 19 letters from senator blumenthal and chairman moran, 68 letters and rfi's. You might not like the answers.
▶ 2:39:20Sec. Collins: That wasn't --chair moran: that was my mistake. We will start the conversation all over again now. I will be really blunt. I think some of those responses are an insult to my intelligence , and perhaps y.
▶ 2:39:42Sec. Collins: Ours, if you respond by giving us the kind of nonsubstantive answer that I think is and answer that I think is a inadequate I'm not going to count it as a real response.
▶ 2:39:55Sec. Collins: That is your prerogative, senator.
▶ 2:39:59Sen. Blumenthal: I am asking for facts, not just acknowledgment of the questions. And I would also encourage you to avoid the use of nondisclosure agreements. With employees. So, we can get more facts from them.
▶ 2:40:16Chair Moran: All right. The hearing is about to conclude. I think our committee members for this participation today. We had a full house. I think the secretary for his presence and testimony today. The hearing record will remain open for five legislative days should a committee member wish to submit additional statements or questions for the record. Mr.
▶ 2:40:39Chair Moran: Secretary, I ask you when the department to respond to any questions for the record that you may receive following today's hearing in a timely manner. Which I guess will be decided by, I hope, me. With that, -- our committee is adjourned.